Ann De Rick – Freud’s Clinical Category of actual Neuroses’ – The Return of the Repressed

THE LETTER 26 (Autumn 2002) pages 120-132


Over the past decade, our society has had to confront the so-called ‘new illnesses of the soul’. More and more, clinicians are confronted with pathologies that do not seem to fit into the three major Freudo-Lacanian diagnostic categories of neurosis, psychosis and perversion. These pathologies are borderline personality disorders, posttraumatic stress disorders, substance abuse, self-mutilation, attention deficit hyperactive disorder, psychosomatic phenomena, etc. Since psychoanalytic treatment is worked out only for the three categories mentioned earlier, especially neurosis, any attempt to treat the new patients in the same way is doomed to fail.

Based on literature studies on these new pathologies, it can be hypothesised that they can be classified under the nosographic label Freud called actual neurosis. In order to confirm this hypothesis, we’ll start with a discussion of actual neurosis as it was described by Freud. Next we will shed light on this theory from a Lacanian point of view, with special reference to Lacan’s view on the emergence of the subject. Then, we will compare the findings of the literature with our theoretical notions. Finally we’ll discuss some implications for treatment.

The return of the repressed

At the beginning of his career as a psychiatrist, Freud introduced a…

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